|
PR PARTIAL REMOVAL OF OVARY(S)
|
Professional
|
Both
|
$1,326.68
|
|
|
Service Code
|
CPT 58920
|
| Hospital Charge Code |
z58920
|
| Min. Negotiated Rate |
$652.52 |
| Max. Negotiated Rate |
$87,100.00 |
| Rate for Payer: Aetna Commercial |
$676.33
|
| Rate for Payer: Aetna Commercial |
$676.33
|
| Rate for Payer: Aetna Medicare |
$676.33
|
| Rate for Payer: Aetna Medicare |
$676.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$898.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$898.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$898.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$898.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$898.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$898.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$898.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$898.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$652.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$652.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$777.78
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$777.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$743.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$743.96
|
| Rate for Payer: Cash Price |
$796.01
|
| Rate for Payer: Cash Price |
$784.81
|
| Rate for Payer: Centivo All Commercial |
$1,048.31
|
| Rate for Payer: Centivo All Commercial |
$1,048.31
|
| Rate for Payer: Cigna All Commercial |
$676.33
|
| Rate for Payer: Cigna All Commercial |
$676.33
|
| Rate for Payer: CORVEL All Commercial |
$676.33
|
| Rate for Payer: CORVEL All Commercial |
$676.33
|
| Rate for Payer: Coventry All Commercial |
$811.60
|
| Rate for Payer: Coventry All Commercial |
$811.60
|
| Rate for Payer: Encore All Commercial |
$676.33
|
| Rate for Payer: Encore All Commercial |
$676.33
|
| Rate for Payer: Frontpath All Commercial |
$938.76
|
| Rate for Payer: Frontpath All Commercial |
$938.76
|
| Rate for Payer: Humana ChoiceCare |
$755.02
|
| Rate for Payer: Humana ChoiceCare |
$755.02
|
| Rate for Payer: Humana Medicare |
$676.33
|
| Rate for Payer: Humana Medicare |
$676.33
|
| Rate for Payer: Lucent All Commercial |
$946.86
|
| Rate for Payer: Lucent All Commercial |
$946.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$939.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$939.00
|
| Rate for Payer: Managed Health Services Medicaid |
$652.52
|
| Rate for Payer: Managed Health Services Medicaid |
$652.52
|
| Rate for Payer: MDWise Medicaid |
$652.52
|
| Rate for Payer: MDWise Medicaid |
$652.52
|
| Rate for Payer: PHCS All Commercial |
$676.33
|
| Rate for Payer: PHCS All Commercial |
$676.33
|
| Rate for Payer: PHP All Commercial |
$863.29
|
| Rate for Payer: PHP All Commercial |
$863.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$676.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$676.33
|
| Rate for Payer: Sagamore Health Network All Products |
$676.33
|
| Rate for Payer: Sagamore Health Network All Products |
$676.33
|
| Rate for Payer: Signature Care EPO |
$836.40
|
| Rate for Payer: Signature Care EPO |
$836.40
|
| Rate for Payer: Signature Care PPO |
$836.40
|
| Rate for Payer: Signature Care PPO |
$836.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87,100.00
|
| Rate for Payer: United Healthcare Commercial |
$789.38
|
| Rate for Payer: United Healthcare Commercial |
$789.38
|
| Rate for Payer: United Healthcare Medicare |
$654.01
|
| Rate for Payer: United Healthcare Medicare |
$654.01
|
|
|
PR PARTIAL REMOVAL/REPAIR,ACROMION
|
Professional
|
Both
|
$1,153.60
|
|
|
Service Code
|
CPT 23130
|
| Hospital Charge Code |
z23130
|
| Min. Negotiated Rate |
$563.89 |
| Max. Negotiated Rate |
$86,700.00 |
| Rate for Payer: Aetna Commercial |
$578.37
|
| Rate for Payer: Aetna Commercial |
$578.37
|
| Rate for Payer: Aetna Medicare |
$578.37
|
| Rate for Payer: Aetna Medicare |
$578.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$769.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$769.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$769.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$769.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$769.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$769.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$769.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$769.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$567.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$567.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$665.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$665.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$636.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$636.21
|
| Rate for Payer: Cash Price |
$692.16
|
| Rate for Payer: Cash Price |
$676.67
|
| Rate for Payer: Centivo All Commercial |
$896.47
|
| Rate for Payer: Centivo All Commercial |
$896.47
|
| Rate for Payer: Cigna All Commercial |
$578.37
|
| Rate for Payer: Cigna All Commercial |
$578.37
|
| Rate for Payer: CORVEL All Commercial |
$578.37
|
| Rate for Payer: CORVEL All Commercial |
$578.37
|
| Rate for Payer: Coventry All Commercial |
$694.04
|
| Rate for Payer: Coventry All Commercial |
$694.04
|
| Rate for Payer: Encore All Commercial |
$578.37
|
| Rate for Payer: Encore All Commercial |
$578.37
|
| Rate for Payer: Frontpath All Commercial |
$802.49
|
| Rate for Payer: Frontpath All Commercial |
$802.49
|
| Rate for Payer: Humana ChoiceCare |
$636.73
|
| Rate for Payer: Humana ChoiceCare |
$636.73
|
| Rate for Payer: Humana Medicare |
$578.37
|
| Rate for Payer: Humana Medicare |
$578.37
|
| Rate for Payer: Lucent All Commercial |
$809.72
|
| Rate for Payer: Lucent All Commercial |
$809.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$925.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$925.00
|
| Rate for Payer: Managed Health Services Medicaid |
$567.39
|
| Rate for Payer: Managed Health Services Medicaid |
$567.39
|
| Rate for Payer: MDWise Medicaid |
$567.39
|
| Rate for Payer: MDWise Medicaid |
$567.39
|
| Rate for Payer: PHCS All Commercial |
$578.37
|
| Rate for Payer: PHCS All Commercial |
$578.37
|
| Rate for Payer: PHP All Commercial |
$981.17
|
| Rate for Payer: PHP All Commercial |
$981.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$578.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$578.37
|
| Rate for Payer: Sagamore Health Network All Products |
$578.37
|
| Rate for Payer: Sagamore Health Network All Products |
$578.37
|
| Rate for Payer: Signature Care EPO |
$852.55
|
| Rate for Payer: Signature Care EPO |
$852.55
|
| Rate for Payer: Signature Care PPO |
$852.55
|
| Rate for Payer: Signature Care PPO |
$852.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$86,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$86,700.00
|
| Rate for Payer: United Healthcare Commercial |
$646.04
|
| Rate for Payer: United Healthcare Commercial |
$646.04
|
| Rate for Payer: United Healthcare Medicare |
$563.89
|
| Rate for Payer: United Healthcare Medicare |
$563.89
|
|
|
PR PART PALMAR FASCIEC,OPEN 1 DIGIT
|
Professional
|
Both
|
$1,564.56
|
|
|
Service Code
|
CPT 26123
|
| Hospital Charge Code |
z26123
|
| Min. Negotiated Rate |
$764.73 |
| Max. Negotiated Rate |
$117,600.00 |
| Rate for Payer: Aetna Commercial |
$781.67
|
| Rate for Payer: Aetna Commercial |
$781.67
|
| Rate for Payer: Aetna Medicare |
$781.67
|
| Rate for Payer: Aetna Medicare |
$781.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,022.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,022.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,022.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,022.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,022.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,022.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,022.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,022.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$769.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$769.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$898.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$898.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$859.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$859.84
|
| Rate for Payer: Cash Price |
$938.74
|
| Rate for Payer: Cash Price |
$917.68
|
| Rate for Payer: Centivo All Commercial |
$1,211.59
|
| Rate for Payer: Centivo All Commercial |
$1,211.59
|
| Rate for Payer: Cigna All Commercial |
$781.67
|
| Rate for Payer: Cigna All Commercial |
$781.67
|
| Rate for Payer: CORVEL All Commercial |
$781.67
|
| Rate for Payer: CORVEL All Commercial |
$781.67
|
| Rate for Payer: Coventry All Commercial |
$938.00
|
| Rate for Payer: Coventry All Commercial |
$938.00
|
| Rate for Payer: Encore All Commercial |
$781.67
|
| Rate for Payer: Encore All Commercial |
$781.67
|
| Rate for Payer: Frontpath All Commercial |
$1,080.05
|
| Rate for Payer: Frontpath All Commercial |
$1,080.05
|
| Rate for Payer: Humana ChoiceCare |
$783.60
|
| Rate for Payer: Humana ChoiceCare |
$783.60
|
| Rate for Payer: Humana Medicare |
$781.67
|
| Rate for Payer: Humana Medicare |
$781.67
|
| Rate for Payer: Lucent All Commercial |
$1,094.34
|
| Rate for Payer: Lucent All Commercial |
$1,094.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,254.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,254.00
|
| Rate for Payer: Managed Health Services Medicaid |
$769.51
|
| Rate for Payer: Managed Health Services Medicaid |
$769.51
|
| Rate for Payer: MDWise Medicaid |
$769.51
|
| Rate for Payer: MDWise Medicaid |
$769.51
|
| Rate for Payer: PHCS All Commercial |
$781.67
|
| Rate for Payer: PHCS All Commercial |
$781.67
|
| Rate for Payer: PHP All Commercial |
$1,330.63
|
| Rate for Payer: PHP All Commercial |
$1,330.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$781.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$781.67
|
| Rate for Payer: Sagamore Health Network All Products |
$781.67
|
| Rate for Payer: Sagamore Health Network All Products |
$781.67
|
| Rate for Payer: Signature Care EPO |
$1,044.65
|
| Rate for Payer: Signature Care EPO |
$1,044.65
|
| Rate for Payer: Signature Care PPO |
$1,044.65
|
| Rate for Payer: Signature Care PPO |
$1,044.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$117,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$117,600.00
|
| Rate for Payer: United Healthcare Commercial |
$870.46
|
| Rate for Payer: United Healthcare Commercial |
$870.46
|
| Rate for Payer: United Healthcare Medicare |
$764.73
|
| Rate for Payer: United Healthcare Medicare |
$764.73
|
|
|
PR PART REMOVAL COLON W ANASTOMOSIS
|
Professional
|
Both
|
$2,428.00
|
|
|
Service Code
|
CPT 44140
|
| Hospital Charge Code |
z44140
|
| Min. Negotiated Rate |
$1,194.18 |
| Max. Negotiated Rate |
$171,400.00 |
| Rate for Payer: Aetna Commercial |
$1,242.33
|
| Rate for Payer: Aetna Commercial |
$1,242.33
|
| Rate for Payer: Aetna Medicare |
$1,242.33
|
| Rate for Payer: Aetna Medicare |
$1,242.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,444.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,444.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,444.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,444.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,444.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,444.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,444.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,444.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,194.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,194.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,428.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,428.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,366.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,366.56
|
| Rate for Payer: Cash Price |
$1,456.80
|
| Rate for Payer: Cash Price |
$1,434.06
|
| Rate for Payer: Centivo All Commercial |
$1,925.61
|
| Rate for Payer: Centivo All Commercial |
$1,925.61
|
| Rate for Payer: Cigna All Commercial |
$1,242.33
|
| Rate for Payer: Cigna All Commercial |
$1,242.33
|
| Rate for Payer: CORVEL All Commercial |
$1,242.33
|
| Rate for Payer: CORVEL All Commercial |
$1,242.33
|
| Rate for Payer: Coventry All Commercial |
$1,490.80
|
| Rate for Payer: Coventry All Commercial |
$1,490.80
|
| Rate for Payer: Encore All Commercial |
$1,242.33
|
| Rate for Payer: Encore All Commercial |
$1,242.33
|
| Rate for Payer: Frontpath All Commercial |
$1,771.50
|
| Rate for Payer: Frontpath All Commercial |
$1,771.50
|
| Rate for Payer: Humana ChoiceCare |
$1,361.00
|
| Rate for Payer: Humana ChoiceCare |
$1,361.00
|
| Rate for Payer: Humana Medicare |
$1,242.33
|
| Rate for Payer: Humana Medicare |
$1,242.33
|
| Rate for Payer: Lucent All Commercial |
$1,739.26
|
| Rate for Payer: Lucent All Commercial |
$1,739.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,837.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,837.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,194.18
|
| Rate for Payer: Managed Health Services Medicaid |
$1,194.18
|
| Rate for Payer: MDWise Medicaid |
$1,194.18
|
| Rate for Payer: MDWise Medicaid |
$1,194.18
|
| Rate for Payer: PHCS All Commercial |
$1,242.33
|
| Rate for Payer: PHCS All Commercial |
$1,242.33
|
| Rate for Payer: PHP All Commercial |
$2,091.34
|
| Rate for Payer: PHP All Commercial |
$2,091.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,242.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,242.33
|
| Rate for Payer: Sagamore Health Network All Products |
$1,242.33
|
| Rate for Payer: Sagamore Health Network All Products |
$1,242.33
|
| Rate for Payer: Signature Care EPO |
$1,722.95
|
| Rate for Payer: Signature Care EPO |
$1,722.95
|
| Rate for Payer: Signature Care PPO |
$1,722.95
|
| Rate for Payer: Signature Care PPO |
$1,722.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$171,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$171,400.00
|
| Rate for Payer: United Healthcare Commercial |
$1,437.54
|
| Rate for Payer: United Healthcare Commercial |
$1,437.54
|
| Rate for Payer: United Healthcare Medicare |
$1,195.05
|
| Rate for Payer: United Healthcare Medicare |
$1,195.05
|
|
|
PR PART REMOVAL COLON W COLOPROC,COLOST
|
Professional
|
Both
|
$3,798.52
|
|
|
Service Code
|
CPT 44146
|
| Hospital Charge Code |
z44146
|
| Min. Negotiated Rate |
$1,844.51 |
| Max. Negotiated Rate |
$268,700.00 |
| Rate for Payer: Aetna Commercial |
$1,948.23
|
| Rate for Payer: Aetna Commercial |
$1,948.23
|
| Rate for Payer: Aetna Medicare |
$1,948.23
|
| Rate for Payer: Aetna Medicare |
$1,948.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,960.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,960.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,960.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,960.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,960.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,960.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,960.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,960.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,868.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,868.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,240.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,240.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,143.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,143.05
|
| Rate for Payer: Cash Price |
$2,279.11
|
| Rate for Payer: Cash Price |
$2,246.86
|
| Rate for Payer: Centivo All Commercial |
$3,019.76
|
| Rate for Payer: Centivo All Commercial |
$3,019.76
|
| Rate for Payer: Cigna All Commercial |
$1,948.23
|
| Rate for Payer: Cigna All Commercial |
$1,948.23
|
| Rate for Payer: CORVEL All Commercial |
$1,948.23
|
| Rate for Payer: CORVEL All Commercial |
$1,948.23
|
| Rate for Payer: Coventry All Commercial |
$2,337.88
|
| Rate for Payer: Coventry All Commercial |
$2,337.88
|
| Rate for Payer: Encore All Commercial |
$1,948.23
|
| Rate for Payer: Encore All Commercial |
$1,948.23
|
| Rate for Payer: Frontpath All Commercial |
$2,756.58
|
| Rate for Payer: Frontpath All Commercial |
$2,756.58
|
| Rate for Payer: Humana ChoiceCare |
$1,844.51
|
| Rate for Payer: Humana ChoiceCare |
$1,844.51
|
| Rate for Payer: Humana Medicare |
$1,948.23
|
| Rate for Payer: Humana Medicare |
$1,948.23
|
| Rate for Payer: Lucent All Commercial |
$2,727.52
|
| Rate for Payer: Lucent All Commercial |
$2,727.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,879.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,879.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,868.26
|
| Rate for Payer: Managed Health Services Medicaid |
$1,868.26
|
| Rate for Payer: MDWise Medicaid |
$1,868.26
|
| Rate for Payer: MDWise Medicaid |
$1,868.26
|
| Rate for Payer: PHCS All Commercial |
$1,948.23
|
| Rate for Payer: PHCS All Commercial |
$1,948.23
|
| Rate for Payer: PHP All Commercial |
$3,276.66
|
| Rate for Payer: PHP All Commercial |
$3,276.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,948.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,948.23
|
| Rate for Payer: Sagamore Health Network All Products |
$1,948.23
|
| Rate for Payer: Sagamore Health Network All Products |
$1,948.23
|
| Rate for Payer: Signature Care EPO |
$2,323.90
|
| Rate for Payer: Signature Care EPO |
$2,323.90
|
| Rate for Payer: Signature Care PPO |
$2,323.90
|
| Rate for Payer: Signature Care PPO |
$2,323.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$268,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$268,700.00
|
| Rate for Payer: United Healthcare Commercial |
$2,241.24
|
| Rate for Payer: United Healthcare Commercial |
$2,241.24
|
| Rate for Payer: United Healthcare Medicare |
$1,872.38
|
| Rate for Payer: United Healthcare Medicare |
$1,872.38
|
|
|
PR PART REMOVAL COLON W COLOPROCTOSTOMY
|
Professional
|
Both
|
$2,991.30
|
|
|
Service Code
|
CPT 44145
|
| Hospital Charge Code |
z44145
|
| Min. Negotiated Rate |
$1,471.24 |
| Max. Negotiated Rate |
$211,400.00 |
| Rate for Payer: Aetna Commercial |
$1,530.39
|
| Rate for Payer: Aetna Commercial |
$1,530.39
|
| Rate for Payer: Aetna Medicare |
$1,530.39
|
| Rate for Payer: Aetna Medicare |
$1,530.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,788.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,788.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,788.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,788.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,788.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,788.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,788.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,788.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,471.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,471.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,759.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,759.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,683.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,683.43
|
| Rate for Payer: Cash Price |
$1,794.78
|
| Rate for Payer: Cash Price |
$1,767.90
|
| Rate for Payer: Centivo All Commercial |
$2,372.10
|
| Rate for Payer: Centivo All Commercial |
$2,372.10
|
| Rate for Payer: Cigna All Commercial |
$1,530.39
|
| Rate for Payer: Cigna All Commercial |
$1,530.39
|
| Rate for Payer: CORVEL All Commercial |
$1,530.39
|
| Rate for Payer: CORVEL All Commercial |
$1,530.39
|
| Rate for Payer: Coventry All Commercial |
$1,836.47
|
| Rate for Payer: Coventry All Commercial |
$1,836.47
|
| Rate for Payer: Encore All Commercial |
$1,530.39
|
| Rate for Payer: Encore All Commercial |
$1,530.39
|
| Rate for Payer: Frontpath All Commercial |
$2,169.32
|
| Rate for Payer: Frontpath All Commercial |
$2,169.32
|
| Rate for Payer: Humana ChoiceCare |
$1,706.66
|
| Rate for Payer: Humana ChoiceCare |
$1,706.66
|
| Rate for Payer: Humana Medicare |
$1,530.39
|
| Rate for Payer: Humana Medicare |
$1,530.39
|
| Rate for Payer: Lucent All Commercial |
$2,142.55
|
| Rate for Payer: Lucent All Commercial |
$2,142.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,265.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,265.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,471.24
|
| Rate for Payer: Managed Health Services Medicaid |
$1,471.24
|
| Rate for Payer: MDWise Medicaid |
$1,471.24
|
| Rate for Payer: MDWise Medicaid |
$1,471.24
|
| Rate for Payer: PHCS All Commercial |
$1,530.39
|
| Rate for Payer: PHCS All Commercial |
$1,530.39
|
| Rate for Payer: PHP All Commercial |
$2,578.18
|
| Rate for Payer: PHP All Commercial |
$2,578.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,530.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,530.39
|
| Rate for Payer: Sagamore Health Network All Products |
$1,530.39
|
| Rate for Payer: Sagamore Health Network All Products |
$1,530.39
|
| Rate for Payer: Signature Care EPO |
$2,149.65
|
| Rate for Payer: Signature Care EPO |
$2,149.65
|
| Rate for Payer: Signature Care PPO |
$2,149.65
|
| Rate for Payer: Signature Care PPO |
$2,149.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$211,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$211,400.00
|
| Rate for Payer: United Healthcare Commercial |
$1,792.78
|
| Rate for Payer: United Healthcare Commercial |
$1,792.78
|
| Rate for Payer: United Healthcare Medicare |
$1,473.25
|
| Rate for Payer: United Healthcare Medicare |
$1,473.25
|
|
|
PR PART REMOVAL COLON W END COLOSTOMY
|
Professional
|
Both
|
$2,982.34
|
|
|
Service Code
|
CPT 44143
|
| Hospital Charge Code |
z44143
|
| Min. Negotiated Rate |
$1,466.83 |
| Max. Negotiated Rate |
$211,200.00 |
| Rate for Payer: Aetna Commercial |
$1,532.84
|
| Rate for Payer: Aetna Commercial |
$1,532.84
|
| Rate for Payer: Aetna Medicare |
$1,532.84
|
| Rate for Payer: Aetna Medicare |
$1,532.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,637.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,637.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,637.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,637.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,637.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,637.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,637.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,637.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,466.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,466.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,762.77
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,762.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,686.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,686.12
|
| Rate for Payer: Cash Price |
$1,789.40
|
| Rate for Payer: Cash Price |
$1,765.97
|
| Rate for Payer: Centivo All Commercial |
$2,375.90
|
| Rate for Payer: Centivo All Commercial |
$2,375.90
|
| Rate for Payer: Cigna All Commercial |
$1,532.84
|
| Rate for Payer: Cigna All Commercial |
$1,532.84
|
| Rate for Payer: CORVEL All Commercial |
$1,532.84
|
| Rate for Payer: CORVEL All Commercial |
$1,532.84
|
| Rate for Payer: Coventry All Commercial |
$1,839.41
|
| Rate for Payer: Coventry All Commercial |
$1,839.41
|
| Rate for Payer: Encore All Commercial |
$1,532.84
|
| Rate for Payer: Encore All Commercial |
$1,532.84
|
| Rate for Payer: Frontpath All Commercial |
$2,184.27
|
| Rate for Payer: Frontpath All Commercial |
$2,184.27
|
| Rate for Payer: Humana ChoiceCare |
$1,541.84
|
| Rate for Payer: Humana ChoiceCare |
$1,541.84
|
| Rate for Payer: Humana Medicare |
$1,532.84
|
| Rate for Payer: Humana Medicare |
$1,532.84
|
| Rate for Payer: Lucent All Commercial |
$2,145.98
|
| Rate for Payer: Lucent All Commercial |
$2,145.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,263.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,263.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,466.83
|
| Rate for Payer: Managed Health Services Medicaid |
$1,466.83
|
| Rate for Payer: MDWise Medicaid |
$1,466.83
|
| Rate for Payer: MDWise Medicaid |
$1,466.83
|
| Rate for Payer: PHCS All Commercial |
$1,532.84
|
| Rate for Payer: PHCS All Commercial |
$1,532.84
|
| Rate for Payer: PHP All Commercial |
$2,575.37
|
| Rate for Payer: PHP All Commercial |
$2,575.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,532.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,532.84
|
| Rate for Payer: Sagamore Health Network All Products |
$1,532.84
|
| Rate for Payer: Sagamore Health Network All Products |
$1,532.84
|
| Rate for Payer: Signature Care EPO |
$1,944.80
|
| Rate for Payer: Signature Care EPO |
$1,944.80
|
| Rate for Payer: Signature Care PPO |
$1,944.80
|
| Rate for Payer: Signature Care PPO |
$1,944.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$211,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$211,200.00
|
| Rate for Payer: United Healthcare Commercial |
$1,771.68
|
| Rate for Payer: United Healthcare Commercial |
$1,771.68
|
| Rate for Payer: United Healthcare Medicare |
$1,471.64
|
| Rate for Payer: United Healthcare Medicare |
$1,471.64
|
|
|
PR PART REMV BONE,DISTAL PHALANX
|
Professional
|
Both
|
$830.46
|
|
|
Service Code
|
CPT 26236
|
| Hospital Charge Code |
z26236
|
| Min. Negotiated Rate |
$404.35 |
| Max. Negotiated Rate |
$62,200.00 |
| Rate for Payer: Aetna Commercial |
$414.05
|
| Rate for Payer: Aetna Commercial |
$414.05
|
| Rate for Payer: Aetna Medicare |
$414.05
|
| Rate for Payer: Aetna Medicare |
$414.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$599.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$599.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$599.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$599.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$599.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$599.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$599.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$599.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$408.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$408.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$476.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$476.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$455.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$455.45
|
| Rate for Payer: Cash Price |
$498.28
|
| Rate for Payer: Cash Price |
$485.22
|
| Rate for Payer: Centivo All Commercial |
$641.78
|
| Rate for Payer: Centivo All Commercial |
$641.78
|
| Rate for Payer: Cigna All Commercial |
$414.05
|
| Rate for Payer: Cigna All Commercial |
$414.05
|
| Rate for Payer: CORVEL All Commercial |
$414.05
|
| Rate for Payer: CORVEL All Commercial |
$414.05
|
| Rate for Payer: Coventry All Commercial |
$496.86
|
| Rate for Payer: Coventry All Commercial |
$496.86
|
| Rate for Payer: Encore All Commercial |
$414.05
|
| Rate for Payer: Encore All Commercial |
$414.05
|
| Rate for Payer: Frontpath All Commercial |
$571.61
|
| Rate for Payer: Frontpath All Commercial |
$571.61
|
| Rate for Payer: Humana ChoiceCare |
$458.46
|
| Rate for Payer: Humana ChoiceCare |
$458.46
|
| Rate for Payer: Humana Medicare |
$414.05
|
| Rate for Payer: Humana Medicare |
$414.05
|
| Rate for Payer: Lucent All Commercial |
$579.67
|
| Rate for Payer: Lucent All Commercial |
$579.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$663.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$663.00
|
| Rate for Payer: Managed Health Services Medicaid |
$408.46
|
| Rate for Payer: Managed Health Services Medicaid |
$408.46
|
| Rate for Payer: MDWise Medicaid |
$408.46
|
| Rate for Payer: MDWise Medicaid |
$408.46
|
| Rate for Payer: PHCS All Commercial |
$414.05
|
| Rate for Payer: PHCS All Commercial |
$414.05
|
| Rate for Payer: PHP All Commercial |
$703.56
|
| Rate for Payer: PHP All Commercial |
$703.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$414.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$414.05
|
| Rate for Payer: Sagamore Health Network All Products |
$414.05
|
| Rate for Payer: Sagamore Health Network All Products |
$414.05
|
| Rate for Payer: Signature Care EPO |
$612.85
|
| Rate for Payer: Signature Care EPO |
$612.85
|
| Rate for Payer: Signature Care PPO |
$612.85
|
| Rate for Payer: Signature Care PPO |
$612.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$62,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$62,200.00
|
| Rate for Payer: United Healthcare Commercial |
$464.70
|
| Rate for Payer: United Healthcare Commercial |
$464.70
|
| Rate for Payer: United Healthcare Medicare |
$404.35
|
| Rate for Payer: United Healthcare Medicare |
$404.35
|
|
|
PR PART REMV BONE METATARSAL HEAD,EA
|
Professional
|
Both
|
$1,126.14
|
|
|
Service Code
|
CPT 28288
|
| Hospital Charge Code |
z28288
|
| Min. Negotiated Rate |
$220.96 |
| Max. Negotiated Rate |
$61,300.00 |
| Rate for Payer: Aetna Commercial |
$408.48
|
| Rate for Payer: Aetna Commercial |
$408.48
|
| Rate for Payer: Aetna Medicare |
$408.48
|
| Rate for Payer: Aetna Medicare |
$408.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$492.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$492.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$492.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$492.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$492.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$492.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$492.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$492.00
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$220.96
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$220.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$553.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$553.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$469.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$469.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$449.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$449.33
|
| Rate for Payer: Cash Price |
$659.12
|
| Rate for Payer: Cash Price |
$675.68
|
| Rate for Payer: Centivo All Commercial |
$633.14
|
| Rate for Payer: Centivo All Commercial |
$633.14
|
| Rate for Payer: Cigna All Commercial |
$408.48
|
| Rate for Payer: Cigna All Commercial |
$408.48
|
| Rate for Payer: CORVEL All Commercial |
$408.48
|
| Rate for Payer: CORVEL All Commercial |
$408.48
|
| Rate for Payer: Coventry All Commercial |
$490.18
|
| Rate for Payer: Coventry All Commercial |
$490.18
|
| Rate for Payer: Encore All Commercial |
$408.48
|
| Rate for Payer: Encore All Commercial |
$408.48
|
| Rate for Payer: Frontpath All Commercial |
$553.54
|
| Rate for Payer: Frontpath All Commercial |
$553.54
|
| Rate for Payer: Humana ChoiceCare |
$412.29
|
| Rate for Payer: Humana ChoiceCare |
$412.29
|
| Rate for Payer: Humana Medicare |
$408.48
|
| Rate for Payer: Humana Medicare |
$408.48
|
| Rate for Payer: Lucent All Commercial |
$571.87
|
| Rate for Payer: Lucent All Commercial |
$571.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$654.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$654.00
|
| Rate for Payer: Managed Health Services Medicaid |
$553.88
|
| Rate for Payer: Managed Health Services Medicaid |
$553.88
|
| Rate for Payer: MDWise Medicaid |
$553.88
|
| Rate for Payer: MDWise Medicaid |
$553.88
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$220.96
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$220.96
|
| Rate for Payer: PHCS All Commercial |
$408.48
|
| Rate for Payer: PHCS All Commercial |
$408.48
|
| Rate for Payer: PHP All Commercial |
$693.70
|
| Rate for Payer: PHP All Commercial |
$693.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$408.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$408.48
|
| Rate for Payer: Sagamore Health Network All Products |
$408.48
|
| Rate for Payer: Sagamore Health Network All Products |
$408.48
|
| Rate for Payer: Signature Care EPO |
$653.65
|
| Rate for Payer: Signature Care EPO |
$653.65
|
| Rate for Payer: Signature Care PPO |
$653.65
|
| Rate for Payer: Signature Care PPO |
$653.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$61,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$61,300.00
|
| Rate for Payer: United Healthcare Commercial |
$473.18
|
| Rate for Payer: United Healthcare Commercial |
$473.18
|
| Rate for Payer: United Healthcare Medicare |
$549.27
|
| Rate for Payer: United Healthcare Medicare |
$549.27
|
|
|
PR PART REMV PHALANX OF TOE
|
Professional
|
Both
|
$893.10
|
|
|
Service Code
|
CPT 28124
|
| Hospital Charge Code |
z28124
|
| Min. Negotiated Rate |
$169.05 |
| Max. Negotiated Rate |
$47,300.00 |
| Rate for Payer: Aetna Commercial |
$314.97
|
| Rate for Payer: Aetna Commercial |
$314.97
|
| Rate for Payer: Aetna Medicare |
$314.97
|
| Rate for Payer: Aetna Medicare |
$314.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$455.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$455.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$455.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$455.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$455.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$455.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$455.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$455.01
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$169.05
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$169.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$439.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$439.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$362.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$362.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$346.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$346.47
|
| Rate for Payer: Cash Price |
$520.73
|
| Rate for Payer: Cash Price |
$535.86
|
| Rate for Payer: Centivo All Commercial |
$488.20
|
| Rate for Payer: Centivo All Commercial |
$488.20
|
| Rate for Payer: Cigna All Commercial |
$314.97
|
| Rate for Payer: Cigna All Commercial |
$314.97
|
| Rate for Payer: CORVEL All Commercial |
$314.97
|
| Rate for Payer: CORVEL All Commercial |
$314.97
|
| Rate for Payer: Coventry All Commercial |
$377.96
|
| Rate for Payer: Coventry All Commercial |
$377.96
|
| Rate for Payer: Encore All Commercial |
$314.97
|
| Rate for Payer: Encore All Commercial |
$314.97
|
| Rate for Payer: Frontpath All Commercial |
$424.45
|
| Rate for Payer: Frontpath All Commercial |
$424.45
|
| Rate for Payer: Humana ChoiceCare |
$365.75
|
| Rate for Payer: Humana ChoiceCare |
$365.75
|
| Rate for Payer: Humana Medicare |
$314.97
|
| Rate for Payer: Humana Medicare |
$314.97
|
| Rate for Payer: Lucent All Commercial |
$440.96
|
| Rate for Payer: Lucent All Commercial |
$440.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.00
|
| Rate for Payer: Managed Health Services Medicaid |
$439.26
|
| Rate for Payer: Managed Health Services Medicaid |
$439.26
|
| Rate for Payer: MDWise Medicaid |
$439.26
|
| Rate for Payer: MDWise Medicaid |
$439.26
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$169.05
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$169.05
|
| Rate for Payer: PHCS All Commercial |
$314.97
|
| Rate for Payer: PHCS All Commercial |
$314.97
|
| Rate for Payer: PHP All Commercial |
$534.95
|
| Rate for Payer: PHP All Commercial |
$534.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$314.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$314.97
|
| Rate for Payer: Sagamore Health Network All Products |
$314.97
|
| Rate for Payer: Sagamore Health Network All Products |
$314.97
|
| Rate for Payer: Signature Care EPO |
$624.75
|
| Rate for Payer: Signature Care EPO |
$624.75
|
| Rate for Payer: Signature Care PPO |
$624.75
|
| Rate for Payer: Signature Care PPO |
$624.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47,300.00
|
| Rate for Payer: United Healthcare Commercial |
$379.83
|
| Rate for Payer: United Healthcare Commercial |
$379.83
|
| Rate for Payer: United Healthcare Medicare |
$433.94
|
| Rate for Payer: United Healthcare Medicare |
$433.94
|
|
|
PR PART SIMPLE REMV VULVA
|
Professional
|
Both
|
$1,095.36
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
z56620
|
| Min. Negotiated Rate |
$535.73 |
| Max. Negotiated Rate |
$71,400.00 |
| Rate for Payer: Aetna Commercial |
$552.75
|
| Rate for Payer: Aetna Commercial |
$552.75
|
| Rate for Payer: Aetna Medicare |
$552.75
|
| Rate for Payer: Aetna Medicare |
$552.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$644.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$644.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$644.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$644.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$644.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$644.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$644.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$644.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$538.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$538.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$635.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$635.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$608.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$608.02
|
| Rate for Payer: Cash Price |
$657.22
|
| Rate for Payer: Cash Price |
$642.88
|
| Rate for Payer: Centivo All Commercial |
$856.76
|
| Rate for Payer: Centivo All Commercial |
$856.76
|
| Rate for Payer: Cigna All Commercial |
$552.75
|
| Rate for Payer: Cigna All Commercial |
$552.75
|
| Rate for Payer: CORVEL All Commercial |
$552.75
|
| Rate for Payer: CORVEL All Commercial |
$552.75
|
| Rate for Payer: Coventry All Commercial |
$663.30
|
| Rate for Payer: Coventry All Commercial |
$663.30
|
| Rate for Payer: Encore All Commercial |
$552.75
|
| Rate for Payer: Encore All Commercial |
$552.75
|
| Rate for Payer: Frontpath All Commercial |
$758.77
|
| Rate for Payer: Frontpath All Commercial |
$758.77
|
| Rate for Payer: Humana ChoiceCare |
$541.00
|
| Rate for Payer: Humana ChoiceCare |
$541.00
|
| Rate for Payer: Humana Medicare |
$552.75
|
| Rate for Payer: Humana Medicare |
$552.75
|
| Rate for Payer: Lucent All Commercial |
$773.85
|
| Rate for Payer: Lucent All Commercial |
$773.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.00
|
| Rate for Payer: Managed Health Services Medicaid |
$538.75
|
| Rate for Payer: Managed Health Services Medicaid |
$538.75
|
| Rate for Payer: MDWise Medicaid |
$538.75
|
| Rate for Payer: MDWise Medicaid |
$538.75
|
| Rate for Payer: PHCS All Commercial |
$552.75
|
| Rate for Payer: PHCS All Commercial |
$552.75
|
| Rate for Payer: PHP All Commercial |
$707.16
|
| Rate for Payer: PHP All Commercial |
$707.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$552.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$552.75
|
| Rate for Payer: Sagamore Health Network All Products |
$552.75
|
| Rate for Payer: Sagamore Health Network All Products |
$552.75
|
| Rate for Payer: Signature Care EPO |
$611.15
|
| Rate for Payer: Signature Care EPO |
$611.15
|
| Rate for Payer: Signature Care PPO |
$611.15
|
| Rate for Payer: Signature Care PPO |
$611.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71,400.00
|
| Rate for Payer: United Healthcare Commercial |
$551.84
|
| Rate for Payer: United Healthcare Commercial |
$551.84
|
| Rate for Payer: United Healthcare Medicare |
$535.73
|
| Rate for Payer: United Healthcare Medicare |
$535.73
|
|
|
PR PELVIC EXAMINATION
|
Professional
|
Both
|
$41.74
|
|
|
Service Code
|
CPT 99459
|
| Hospital Charge Code |
z99459
|
| Min. Negotiated Rate |
$20.53 |
| Max. Negotiated Rate |
$20.53 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$20.53
|
| Rate for Payer: Cash Price |
$25.04
|
| Rate for Payer: Managed Health Services Medicaid |
$20.53
|
| Rate for Payer: MDWise Medicaid |
$20.53
|
|
|
PR PELVIC EXAMINATION W ANESTH
|
Professional
|
Both
|
$196.46
|
|
|
Service Code
|
CPT 57410
|
| Hospital Charge Code |
z57410
|
| Min. Negotiated Rate |
$95.83 |
| Max. Negotiated Rate |
$12,800.00 |
| Rate for Payer: Aetna Commercial |
$98.85
|
| Rate for Payer: Aetna Commercial |
$98.85
|
| Rate for Payer: Aetna Medicare |
$98.85
|
| Rate for Payer: Aetna Medicare |
$98.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$193.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$193.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$96.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$96.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$113.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$113.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$108.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$108.73
|
| Rate for Payer: Cash Price |
$117.88
|
| Rate for Payer: Cash Price |
$115.00
|
| Rate for Payer: Centivo All Commercial |
$153.22
|
| Rate for Payer: Centivo All Commercial |
$153.22
|
| Rate for Payer: Cigna All Commercial |
$98.85
|
| Rate for Payer: Cigna All Commercial |
$98.85
|
| Rate for Payer: CORVEL All Commercial |
$98.85
|
| Rate for Payer: CORVEL All Commercial |
$98.85
|
| Rate for Payer: Coventry All Commercial |
$118.62
|
| Rate for Payer: Coventry All Commercial |
$118.62
|
| Rate for Payer: Encore All Commercial |
$98.85
|
| Rate for Payer: Encore All Commercial |
$98.85
|
| Rate for Payer: Frontpath All Commercial |
$136.79
|
| Rate for Payer: Frontpath All Commercial |
$136.79
|
| Rate for Payer: Humana ChoiceCare |
$116.82
|
| Rate for Payer: Humana ChoiceCare |
$116.82
|
| Rate for Payer: Humana Medicare |
$98.85
|
| Rate for Payer: Humana Medicare |
$98.85
|
| Rate for Payer: Lucent All Commercial |
$138.39
|
| Rate for Payer: Lucent All Commercial |
$138.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$138.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$138.00
|
| Rate for Payer: Managed Health Services Medicaid |
$96.63
|
| Rate for Payer: Managed Health Services Medicaid |
$96.63
|
| Rate for Payer: MDWise Medicaid |
$96.63
|
| Rate for Payer: MDWise Medicaid |
$96.63
|
| Rate for Payer: PHCS All Commercial |
$98.85
|
| Rate for Payer: PHCS All Commercial |
$98.85
|
| Rate for Payer: PHP All Commercial |
$126.49
|
| Rate for Payer: PHP All Commercial |
$126.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$98.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$98.85
|
| Rate for Payer: Sagamore Health Network All Products |
$98.85
|
| Rate for Payer: Sagamore Health Network All Products |
$98.85
|
| Rate for Payer: Signature Care EPO |
$168.05
|
| Rate for Payer: Signature Care EPO |
$168.05
|
| Rate for Payer: Signature Care PPO |
$168.05
|
| Rate for Payer: Signature Care PPO |
$168.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,800.00
|
| Rate for Payer: United Healthcare Commercial |
$120.59
|
| Rate for Payer: United Healthcare Commercial |
$120.59
|
| Rate for Payer: United Healthcare Medicare |
$95.83
|
| Rate for Payer: United Healthcare Medicare |
$95.83
|
|
|
PR PELVIS/HIP JOINT SURGERY UNLISTED
|
Professional
|
Both
|
$1,312.41
|
|
|
Service Code
|
CPT 27299
|
| Hospital Charge Code |
z27299
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,115.55 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$0.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$0.01
|
| Rate for Payer: Cash Price |
$787.45
|
| Rate for Payer: Cash Price |
$787.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,115.55
|
| Rate for Payer: Signature Care EPO |
$836.66
|
| Rate for Payer: Signature Care PPO |
$836.66
|
|
|
PR PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
CPT 95004
|
| Hospital Charge Code |
z95004
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$3.62
|
| Rate for Payer: Aetna Commercial |
$3.62
|
| Rate for Payer: Aetna Medicare |
$3.62
|
| Rate for Payer: Aetna Medicare |
$3.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$6.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$6.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$6.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$6.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$6.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$6.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$6.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$6.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$3.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$3.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3.98
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cash Price |
$3.91
|
| Rate for Payer: Centivo All Commercial |
$5.61
|
| Rate for Payer: Centivo All Commercial |
$5.61
|
| Rate for Payer: Cigna All Commercial |
$3.62
|
| Rate for Payer: Cigna All Commercial |
$3.62
|
| Rate for Payer: CORVEL All Commercial |
$3.62
|
| Rate for Payer: CORVEL All Commercial |
$3.62
|
| Rate for Payer: Coventry All Commercial |
$4.34
|
| Rate for Payer: Coventry All Commercial |
$4.34
|
| Rate for Payer: Encore All Commercial |
$3.62
|
| Rate for Payer: Encore All Commercial |
$3.62
|
| Rate for Payer: Frontpath All Commercial |
$4.70
|
| Rate for Payer: Frontpath All Commercial |
$4.70
|
| Rate for Payer: Humana ChoiceCare |
$4.76
|
| Rate for Payer: Humana ChoiceCare |
$4.76
|
| Rate for Payer: Humana Medicare |
$3.62
|
| Rate for Payer: Humana Medicare |
$3.62
|
| Rate for Payer: Lucent All Commercial |
$5.07
|
| Rate for Payer: Lucent All Commercial |
$5.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5.00
|
| Rate for Payer: Managed Health Services Medicaid |
$3.20
|
| Rate for Payer: Managed Health Services Medicaid |
$3.20
|
| Rate for Payer: MDWise Medicaid |
$3.20
|
| Rate for Payer: MDWise Medicaid |
$3.20
|
| Rate for Payer: PHCS All Commercial |
$3.62
|
| Rate for Payer: PHCS All Commercial |
$3.62
|
| Rate for Payer: PHP All Commercial |
$4.02
|
| Rate for Payer: PHP All Commercial |
$4.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3.62
|
| Rate for Payer: Sagamore Health Network All Products |
$3.62
|
| Rate for Payer: Sagamore Health Network All Products |
$3.62
|
| Rate for Payer: Signature Care EPO |
$4.97
|
| Rate for Payer: Signature Care EPO |
$4.97
|
| Rate for Payer: Signature Care PPO |
$4.97
|
| Rate for Payer: Signature Care PPO |
$4.97
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$400.00
|
| Rate for Payer: United Healthcare Commercial |
$6.51
|
| Rate for Payer: United Healthcare Commercial |
$6.51
|
| Rate for Payer: United Healthcare Medicare |
$3.50
|
| Rate for Payer: United Healthcare Medicare |
$3.50
|
|
|
PR PERCUT FIX CARPOMETACAR DISLOC,NON-THUMB
|
Professional
|
Both
|
$961.82
|
|
|
Service Code
|
CPT 26676
|
| Hospital Charge Code |
z26676
|
| Min. Negotiated Rate |
$469.35 |
| Max. Negotiated Rate |
$72,200.00 |
| Rate for Payer: Aetna Commercial |
$478.10
|
| Rate for Payer: Aetna Commercial |
$478.10
|
| Rate for Payer: Aetna Medicare |
$478.10
|
| Rate for Payer: Aetna Medicare |
$478.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$585.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$585.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$473.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$473.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$549.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$549.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$525.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$525.91
|
| Rate for Payer: Cash Price |
$577.09
|
| Rate for Payer: Cash Price |
$563.22
|
| Rate for Payer: Centivo All Commercial |
$741.05
|
| Rate for Payer: Centivo All Commercial |
$741.05
|
| Rate for Payer: Cigna All Commercial |
$478.10
|
| Rate for Payer: Cigna All Commercial |
$478.10
|
| Rate for Payer: CORVEL All Commercial |
$478.10
|
| Rate for Payer: CORVEL All Commercial |
$478.10
|
| Rate for Payer: Coventry All Commercial |
$573.72
|
| Rate for Payer: Coventry All Commercial |
$573.72
|
| Rate for Payer: Encore All Commercial |
$478.10
|
| Rate for Payer: Encore All Commercial |
$478.10
|
| Rate for Payer: Frontpath All Commercial |
$656.73
|
| Rate for Payer: Frontpath All Commercial |
$656.73
|
| Rate for Payer: Humana ChoiceCare |
$523.28
|
| Rate for Payer: Humana ChoiceCare |
$523.28
|
| Rate for Payer: Humana Medicare |
$478.10
|
| Rate for Payer: Humana Medicare |
$478.10
|
| Rate for Payer: Lucent All Commercial |
$669.34
|
| Rate for Payer: Lucent All Commercial |
$669.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$770.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$770.00
|
| Rate for Payer: Managed Health Services Medicaid |
$473.06
|
| Rate for Payer: Managed Health Services Medicaid |
$473.06
|
| Rate for Payer: MDWise Medicaid |
$473.06
|
| Rate for Payer: MDWise Medicaid |
$473.06
|
| Rate for Payer: PHCS All Commercial |
$478.10
|
| Rate for Payer: PHCS All Commercial |
$478.10
|
| Rate for Payer: PHP All Commercial |
$816.66
|
| Rate for Payer: PHP All Commercial |
$816.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$478.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$478.10
|
| Rate for Payer: Sagamore Health Network All Products |
$478.10
|
| Rate for Payer: Sagamore Health Network All Products |
$478.10
|
| Rate for Payer: Signature Care EPO |
$708.05
|
| Rate for Payer: Signature Care EPO |
$708.05
|
| Rate for Payer: Signature Care PPO |
$708.05
|
| Rate for Payer: Signature Care PPO |
$708.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$72,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$72,200.00
|
| Rate for Payer: United Healthcare Commercial |
$522.05
|
| Rate for Payer: United Healthcare Commercial |
$522.05
|
| Rate for Payer: United Healthcare Medicare |
$469.35
|
| Rate for Payer: United Healthcare Medicare |
$469.35
|
|
|
PR PERCUT FIX DISTAL FEMUR
|
Professional
|
Both
|
$1,257.18
|
|
|
Service Code
|
CPT 27509
|
| Hospital Charge Code |
z27509
|
| Min. Negotiated Rate |
$617.41 |
| Max. Negotiated Rate |
$94,900.00 |
| Rate for Payer: Aetna Commercial |
$634.96
|
| Rate for Payer: Aetna Commercial |
$634.96
|
| Rate for Payer: Aetna Medicare |
$634.96
|
| Rate for Payer: Aetna Medicare |
$634.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$691.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$691.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$691.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$691.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$691.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$691.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$691.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$691.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$618.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$618.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$730.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$730.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$698.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$698.46
|
| Rate for Payer: Cash Price |
$754.31
|
| Rate for Payer: Cash Price |
$740.89
|
| Rate for Payer: Centivo All Commercial |
$984.19
|
| Rate for Payer: Centivo All Commercial |
$984.19
|
| Rate for Payer: Cigna All Commercial |
$634.96
|
| Rate for Payer: Cigna All Commercial |
$634.96
|
| Rate for Payer: CORVEL All Commercial |
$634.96
|
| Rate for Payer: CORVEL All Commercial |
$634.96
|
| Rate for Payer: Coventry All Commercial |
$761.95
|
| Rate for Payer: Coventry All Commercial |
$761.95
|
| Rate for Payer: Encore All Commercial |
$634.96
|
| Rate for Payer: Encore All Commercial |
$634.96
|
| Rate for Payer: Frontpath All Commercial |
$878.28
|
| Rate for Payer: Frontpath All Commercial |
$878.28
|
| Rate for Payer: Humana ChoiceCare |
$677.32
|
| Rate for Payer: Humana ChoiceCare |
$677.32
|
| Rate for Payer: Humana Medicare |
$634.96
|
| Rate for Payer: Humana Medicare |
$634.96
|
| Rate for Payer: Lucent All Commercial |
$888.94
|
| Rate for Payer: Lucent All Commercial |
$888.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,013.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,013.00
|
| Rate for Payer: Managed Health Services Medicaid |
$618.33
|
| Rate for Payer: Managed Health Services Medicaid |
$618.33
|
| Rate for Payer: MDWise Medicaid |
$618.33
|
| Rate for Payer: MDWise Medicaid |
$618.33
|
| Rate for Payer: PHCS All Commercial |
$634.96
|
| Rate for Payer: PHCS All Commercial |
$634.96
|
| Rate for Payer: PHP All Commercial |
$1,074.29
|
| Rate for Payer: PHP All Commercial |
$1,074.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$634.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$634.96
|
| Rate for Payer: Sagamore Health Network All Products |
$634.96
|
| Rate for Payer: Sagamore Health Network All Products |
$634.96
|
| Rate for Payer: Signature Care EPO |
$905.25
|
| Rate for Payer: Signature Care EPO |
$905.25
|
| Rate for Payer: Signature Care PPO |
$905.25
|
| Rate for Payer: Signature Care PPO |
$905.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$94,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$94,900.00
|
| Rate for Payer: United Healthcare Commercial |
$688.29
|
| Rate for Payer: United Healthcare Commercial |
$688.29
|
| Rate for Payer: United Healthcare Medicare |
$617.41
|
| Rate for Payer: United Healthcare Medicare |
$617.41
|
|
|
PR PERCUT FIX HUM SUPRACONDYLAR FX
|
Professional
|
Both
|
$1,468.20
|
|
|
Service Code
|
CPT 24538
|
| Hospital Charge Code |
z24538
|
| Min. Negotiated Rate |
$719.72 |
| Max. Negotiated Rate |
$110,700.00 |
| Rate for Payer: Aetna Commercial |
$739.83
|
| Rate for Payer: Aetna Commercial |
$739.83
|
| Rate for Payer: Aetna Medicare |
$739.83
|
| Rate for Payer: Aetna Medicare |
$739.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$906.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$906.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$722.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$722.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$850.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$850.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$813.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$813.81
|
| Rate for Payer: Cash Price |
$880.92
|
| Rate for Payer: Cash Price |
$863.66
|
| Rate for Payer: Centivo All Commercial |
$1,146.74
|
| Rate for Payer: Centivo All Commercial |
$1,146.74
|
| Rate for Payer: Cigna All Commercial |
$739.83
|
| Rate for Payer: Cigna All Commercial |
$739.83
|
| Rate for Payer: CORVEL All Commercial |
$739.83
|
| Rate for Payer: CORVEL All Commercial |
$739.83
|
| Rate for Payer: Coventry All Commercial |
$887.80
|
| Rate for Payer: Coventry All Commercial |
$887.80
|
| Rate for Payer: Encore All Commercial |
$739.83
|
| Rate for Payer: Encore All Commercial |
$739.83
|
| Rate for Payer: Frontpath All Commercial |
$1,025.60
|
| Rate for Payer: Frontpath All Commercial |
$1,025.60
|
| Rate for Payer: Humana ChoiceCare |
$787.78
|
| Rate for Payer: Humana ChoiceCare |
$787.78
|
| Rate for Payer: Humana Medicare |
$739.83
|
| Rate for Payer: Humana Medicare |
$739.83
|
| Rate for Payer: Lucent All Commercial |
$1,035.76
|
| Rate for Payer: Lucent All Commercial |
$1,035.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,181.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,181.00
|
| Rate for Payer: Managed Health Services Medicaid |
$722.12
|
| Rate for Payer: Managed Health Services Medicaid |
$722.12
|
| Rate for Payer: MDWise Medicaid |
$722.12
|
| Rate for Payer: MDWise Medicaid |
$722.12
|
| Rate for Payer: PHCS All Commercial |
$739.83
|
| Rate for Payer: PHCS All Commercial |
$739.83
|
| Rate for Payer: PHP All Commercial |
$1,252.31
|
| Rate for Payer: PHP All Commercial |
$1,252.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$739.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$739.83
|
| Rate for Payer: Sagamore Health Network All Products |
$739.83
|
| Rate for Payer: Sagamore Health Network All Products |
$739.83
|
| Rate for Payer: Signature Care EPO |
$1,052.30
|
| Rate for Payer: Signature Care EPO |
$1,052.30
|
| Rate for Payer: Signature Care PPO |
$1,052.30
|
| Rate for Payer: Signature Care PPO |
$1,052.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$110,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$110,700.00
|
| Rate for Payer: United Healthcare Commercial |
$798.78
|
| Rate for Payer: United Healthcare Commercial |
$798.78
|
| Rate for Payer: United Healthcare Medicare |
$719.72
|
| Rate for Payer: United Healthcare Medicare |
$719.72
|
|
|
PR PERCUT FIX PROX/NECK FEMUR FX
|
Professional
|
Both
|
$1,674.42
|
|
|
Service Code
|
CPT 27235
|
| Hospital Charge Code |
z27235
|
| Min. Negotiated Rate |
$820.57 |
| Max. Negotiated Rate |
$126,200.00 |
| Rate for Payer: Aetna Commercial |
$844.63
|
| Rate for Payer: Aetna Commercial |
$844.63
|
| Rate for Payer: Aetna Medicare |
$844.63
|
| Rate for Payer: Aetna Medicare |
$844.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,202.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,202.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,202.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,202.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,202.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,202.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,202.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,202.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$823.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$823.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$971.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$971.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$929.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$929.09
|
| Rate for Payer: Cash Price |
$1,004.65
|
| Rate for Payer: Cash Price |
$984.68
|
| Rate for Payer: Centivo All Commercial |
$1,309.18
|
| Rate for Payer: Centivo All Commercial |
$1,309.18
|
| Rate for Payer: Cigna All Commercial |
$844.63
|
| Rate for Payer: Cigna All Commercial |
$844.63
|
| Rate for Payer: CORVEL All Commercial |
$844.63
|
| Rate for Payer: CORVEL All Commercial |
$844.63
|
| Rate for Payer: Coventry All Commercial |
$1,013.56
|
| Rate for Payer: Coventry All Commercial |
$1,013.56
|
| Rate for Payer: Encore All Commercial |
$844.63
|
| Rate for Payer: Encore All Commercial |
$844.63
|
| Rate for Payer: Frontpath All Commercial |
$1,179.89
|
| Rate for Payer: Frontpath All Commercial |
$1,179.89
|
| Rate for Payer: Humana ChoiceCare |
$945.15
|
| Rate for Payer: Humana ChoiceCare |
$945.15
|
| Rate for Payer: Humana Medicare |
$844.63
|
| Rate for Payer: Humana Medicare |
$844.63
|
| Rate for Payer: Lucent All Commercial |
$1,182.48
|
| Rate for Payer: Lucent All Commercial |
$1,182.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,346.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,346.00
|
| Rate for Payer: Managed Health Services Medicaid |
$823.54
|
| Rate for Payer: Managed Health Services Medicaid |
$823.54
|
| Rate for Payer: MDWise Medicaid |
$823.54
|
| Rate for Payer: MDWise Medicaid |
$823.54
|
| Rate for Payer: PHCS All Commercial |
$844.63
|
| Rate for Payer: PHCS All Commercial |
$844.63
|
| Rate for Payer: PHP All Commercial |
$1,427.79
|
| Rate for Payer: PHP All Commercial |
$1,427.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$844.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$844.63
|
| Rate for Payer: Sagamore Health Network All Products |
$844.63
|
| Rate for Payer: Sagamore Health Network All Products |
$844.63
|
| Rate for Payer: Signature Care EPO |
$1,263.10
|
| Rate for Payer: Signature Care EPO |
$1,263.10
|
| Rate for Payer: Signature Care PPO |
$1,263.10
|
| Rate for Payer: Signature Care PPO |
$1,263.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126,200.00
|
| Rate for Payer: United Healthcare Commercial |
$993.44
|
| Rate for Payer: United Healthcare Commercial |
$993.44
|
| Rate for Payer: United Healthcare Medicare |
$820.57
|
| Rate for Payer: United Healthcare Medicare |
$820.57
|
|
|
PR PERCUT RX DIST FINGR FX
|
Professional
|
Both
|
$802.28
|
|
|
Service Code
|
CPT 26756
|
| Hospital Charge Code |
z26756
|
| Min. Negotiated Rate |
$391.56 |
| Max. Negotiated Rate |
$60,200.00 |
| Rate for Payer: Aetna Commercial |
$399.24
|
| Rate for Payer: Aetna Commercial |
$399.24
|
| Rate for Payer: Aetna Medicare |
$399.24
|
| Rate for Payer: Aetna Medicare |
$399.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$432.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$432.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$432.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$432.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$432.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$432.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$432.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$432.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$394.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$394.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$459.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$459.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$439.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$439.16
|
| Rate for Payer: Cash Price |
$481.37
|
| Rate for Payer: Cash Price |
$469.87
|
| Rate for Payer: Centivo All Commercial |
$618.82
|
| Rate for Payer: Centivo All Commercial |
$618.82
|
| Rate for Payer: Cigna All Commercial |
$399.24
|
| Rate for Payer: Cigna All Commercial |
$399.24
|
| Rate for Payer: CORVEL All Commercial |
$399.24
|
| Rate for Payer: CORVEL All Commercial |
$399.24
|
| Rate for Payer: Coventry All Commercial |
$479.09
|
| Rate for Payer: Coventry All Commercial |
$479.09
|
| Rate for Payer: Encore All Commercial |
$399.24
|
| Rate for Payer: Encore All Commercial |
$399.24
|
| Rate for Payer: Frontpath All Commercial |
$547.88
|
| Rate for Payer: Frontpath All Commercial |
$547.88
|
| Rate for Payer: Humana ChoiceCare |
$431.78
|
| Rate for Payer: Humana ChoiceCare |
$431.78
|
| Rate for Payer: Humana Medicare |
$399.24
|
| Rate for Payer: Humana Medicare |
$399.24
|
| Rate for Payer: Lucent All Commercial |
$558.94
|
| Rate for Payer: Lucent All Commercial |
$558.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$642.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$642.00
|
| Rate for Payer: Managed Health Services Medicaid |
$394.60
|
| Rate for Payer: Managed Health Services Medicaid |
$394.60
|
| Rate for Payer: MDWise Medicaid |
$394.60
|
| Rate for Payer: MDWise Medicaid |
$394.60
|
| Rate for Payer: PHCS All Commercial |
$399.24
|
| Rate for Payer: PHCS All Commercial |
$399.24
|
| Rate for Payer: PHP All Commercial |
$681.31
|
| Rate for Payer: PHP All Commercial |
$681.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$399.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$399.24
|
| Rate for Payer: Sagamore Health Network All Products |
$399.24
|
| Rate for Payer: Sagamore Health Network All Products |
$399.24
|
| Rate for Payer: Signature Care EPO |
$595.85
|
| Rate for Payer: Signature Care EPO |
$595.85
|
| Rate for Payer: Signature Care PPO |
$595.85
|
| Rate for Payer: Signature Care PPO |
$595.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$60,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$60,200.00
|
| Rate for Payer: United Healthcare Commercial |
$430.90
|
| Rate for Payer: United Healthcare Commercial |
$430.90
|
| Rate for Payer: United Healthcare Medicare |
$391.56
|
| Rate for Payer: United Healthcare Medicare |
$391.56
|
|
|
PR PERCUT RX I-P JT,TOE DISLOC
|
Professional
|
Both
|
$333.02
|
|
|
Service Code
|
CPT 28666
|
| Hospital Charge Code |
z28666
|
| Min. Negotiated Rate |
$163.67 |
| Max. Negotiated Rate |
$25,200.00 |
| Rate for Payer: Aetna Commercial |
$169.87
|
| Rate for Payer: Aetna Commercial |
$169.87
|
| Rate for Payer: Aetna Medicare |
$169.87
|
| Rate for Payer: Aetna Medicare |
$169.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$238.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$238.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$238.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$238.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$238.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$238.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$238.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$238.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$163.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$163.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$195.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$195.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$186.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$186.86
|
| Rate for Payer: Cash Price |
$199.81
|
| Rate for Payer: Cash Price |
$196.40
|
| Rate for Payer: Centivo All Commercial |
$263.30
|
| Rate for Payer: Centivo All Commercial |
$263.30
|
| Rate for Payer: Cigna All Commercial |
$169.87
|
| Rate for Payer: Cigna All Commercial |
$169.87
|
| Rate for Payer: CORVEL All Commercial |
$169.87
|
| Rate for Payer: CORVEL All Commercial |
$169.87
|
| Rate for Payer: Coventry All Commercial |
$203.84
|
| Rate for Payer: Coventry All Commercial |
$203.84
|
| Rate for Payer: Encore All Commercial |
$169.87
|
| Rate for Payer: Encore All Commercial |
$169.87
|
| Rate for Payer: Frontpath All Commercial |
$228.18
|
| Rate for Payer: Frontpath All Commercial |
$228.18
|
| Rate for Payer: Humana ChoiceCare |
$226.76
|
| Rate for Payer: Humana ChoiceCare |
$226.76
|
| Rate for Payer: Humana Medicare |
$169.87
|
| Rate for Payer: Humana Medicare |
$169.87
|
| Rate for Payer: Lucent All Commercial |
$237.82
|
| Rate for Payer: Lucent All Commercial |
$237.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$268.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$268.00
|
| Rate for Payer: Managed Health Services Medicaid |
$163.80
|
| Rate for Payer: Managed Health Services Medicaid |
$163.80
|
| Rate for Payer: MDWise Medicaid |
$163.80
|
| Rate for Payer: MDWise Medicaid |
$163.80
|
| Rate for Payer: PHCS All Commercial |
$169.87
|
| Rate for Payer: PHCS All Commercial |
$169.87
|
| Rate for Payer: PHP All Commercial |
$284.78
|
| Rate for Payer: PHP All Commercial |
$284.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$169.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$169.87
|
| Rate for Payer: Sagamore Health Network All Products |
$169.87
|
| Rate for Payer: Sagamore Health Network All Products |
$169.87
|
| Rate for Payer: Signature Care EPO |
$288.78
|
| Rate for Payer: Signature Care EPO |
$288.78
|
| Rate for Payer: Signature Care PPO |
$288.78
|
| Rate for Payer: Signature Care PPO |
$288.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$25,200.00
|
| Rate for Payer: United Healthcare Commercial |
$214.31
|
| Rate for Payer: United Healthcare Commercial |
$214.31
|
| Rate for Payer: United Healthcare Medicare |
$163.67
|
| Rate for Payer: United Healthcare Medicare |
$163.67
|
|
|
PR PERCUT RX PROX/MID FING SHFT FX
|
Professional
|
Both
|
$895.62
|
|
|
Service Code
|
CPT 26727
|
| Hospital Charge Code |
z26727
|
| Min. Negotiated Rate |
$436.60 |
| Max. Negotiated Rate |
$67,100.00 |
| Rate for Payer: Aetna Commercial |
$445.51
|
| Rate for Payer: Aetna Commercial |
$445.51
|
| Rate for Payer: Aetna Medicare |
$445.51
|
| Rate for Payer: Aetna Medicare |
$445.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$499.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$499.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$499.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$499.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$499.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$499.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$499.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$499.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$440.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$440.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$512.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$512.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$490.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$490.06
|
| Rate for Payer: Cash Price |
$537.37
|
| Rate for Payer: Cash Price |
$523.92
|
| Rate for Payer: Centivo All Commercial |
$690.54
|
| Rate for Payer: Centivo All Commercial |
$690.54
|
| Rate for Payer: Cigna All Commercial |
$445.51
|
| Rate for Payer: Cigna All Commercial |
$445.51
|
| Rate for Payer: CORVEL All Commercial |
$445.51
|
| Rate for Payer: CORVEL All Commercial |
$445.51
|
| Rate for Payer: Coventry All Commercial |
$534.61
|
| Rate for Payer: Coventry All Commercial |
$534.61
|
| Rate for Payer: Encore All Commercial |
$445.51
|
| Rate for Payer: Encore All Commercial |
$445.51
|
| Rate for Payer: Frontpath All Commercial |
$612.27
|
| Rate for Payer: Frontpath All Commercial |
$612.27
|
| Rate for Payer: Humana ChoiceCare |
$491.10
|
| Rate for Payer: Humana ChoiceCare |
$491.10
|
| Rate for Payer: Humana Medicare |
$445.51
|
| Rate for Payer: Humana Medicare |
$445.51
|
| Rate for Payer: Lucent All Commercial |
$623.71
|
| Rate for Payer: Lucent All Commercial |
$623.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$716.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$716.00
|
| Rate for Payer: Managed Health Services Medicaid |
$440.50
|
| Rate for Payer: Managed Health Services Medicaid |
$440.50
|
| Rate for Payer: MDWise Medicaid |
$440.50
|
| Rate for Payer: MDWise Medicaid |
$440.50
|
| Rate for Payer: PHCS All Commercial |
$445.51
|
| Rate for Payer: PHCS All Commercial |
$445.51
|
| Rate for Payer: PHP All Commercial |
$759.68
|
| Rate for Payer: PHP All Commercial |
$759.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$445.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$445.51
|
| Rate for Payer: Sagamore Health Network All Products |
$445.51
|
| Rate for Payer: Sagamore Health Network All Products |
$445.51
|
| Rate for Payer: Signature Care EPO |
$668.10
|
| Rate for Payer: Signature Care EPO |
$668.10
|
| Rate for Payer: Signature Care PPO |
$668.10
|
| Rate for Payer: Signature Care PPO |
$668.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$67,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$67,100.00
|
| Rate for Payer: United Healthcare Commercial |
$489.66
|
| Rate for Payer: United Healthcare Commercial |
$489.66
|
| Rate for Payer: United Healthcare Medicare |
$436.60
|
| Rate for Payer: United Healthcare Medicare |
$436.60
|
|
|
PR PERCUT SKELETAL FIX, DISTAL RADIUS FX
|
Professional
|
Both
|
$1,251.38
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
z25606
|
| Min. Negotiated Rate |
$610.56 |
| Max. Negotiated Rate |
$93,800.00 |
| Rate for Payer: Aetna Commercial |
$623.58
|
| Rate for Payer: Aetna Commercial |
$623.58
|
| Rate for Payer: Aetna Medicare |
$623.58
|
| Rate for Payer: Aetna Medicare |
$623.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$753.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$753.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$753.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$753.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$753.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$753.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$753.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$753.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$615.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$615.48
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$717.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$717.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$685.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$685.94
|
| Rate for Payer: Cash Price |
$750.83
|
| Rate for Payer: Cash Price |
$732.67
|
| Rate for Payer: Centivo All Commercial |
$966.55
|
| Rate for Payer: Centivo All Commercial |
$966.55
|
| Rate for Payer: Cigna All Commercial |
$623.58
|
| Rate for Payer: Cigna All Commercial |
$623.58
|
| Rate for Payer: CORVEL All Commercial |
$623.58
|
| Rate for Payer: CORVEL All Commercial |
$623.58
|
| Rate for Payer: Coventry All Commercial |
$748.30
|
| Rate for Payer: Coventry All Commercial |
$748.30
|
| Rate for Payer: Encore All Commercial |
$623.58
|
| Rate for Payer: Encore All Commercial |
$623.58
|
| Rate for Payer: Frontpath All Commercial |
$863.99
|
| Rate for Payer: Frontpath All Commercial |
$863.99
|
| Rate for Payer: Humana ChoiceCare |
$675.24
|
| Rate for Payer: Humana ChoiceCare |
$675.24
|
| Rate for Payer: Humana Medicare |
$623.58
|
| Rate for Payer: Humana Medicare |
$623.58
|
| Rate for Payer: Lucent All Commercial |
$873.01
|
| Rate for Payer: Lucent All Commercial |
$873.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,001.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,001.00
|
| Rate for Payer: Managed Health Services Medicaid |
$615.48
|
| Rate for Payer: Managed Health Services Medicaid |
$615.48
|
| Rate for Payer: MDWise Medicaid |
$615.48
|
| Rate for Payer: MDWise Medicaid |
$615.48
|
| Rate for Payer: PHCS All Commercial |
$623.58
|
| Rate for Payer: PHCS All Commercial |
$623.58
|
| Rate for Payer: PHP All Commercial |
$1,062.38
|
| Rate for Payer: PHP All Commercial |
$1,062.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$623.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$623.58
|
| Rate for Payer: Sagamore Health Network All Products |
$623.58
|
| Rate for Payer: Sagamore Health Network All Products |
$623.58
|
| Rate for Payer: Signature Care EPO |
$916.30
|
| Rate for Payer: Signature Care EPO |
$916.30
|
| Rate for Payer: Signature Care PPO |
$916.30
|
| Rate for Payer: Signature Care PPO |
$916.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$93,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$93,800.00
|
| Rate for Payer: United Healthcare Commercial |
$704.64
|
| Rate for Payer: United Healthcare Commercial |
$704.64
|
| Rate for Payer: United Healthcare Medicare |
$610.56
|
| Rate for Payer: United Healthcare Medicare |
$610.56
|
|
|
PR PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$84.32
|
|
|
Service Code
|
CPT 93286
|
| Hospital Charge Code |
z93286
|
| Min. Negotiated Rate |
$31.99 |
| Max. Negotiated Rate |
$6,500.00 |
| Rate for Payer: Aetna Commercial |
$44.96
|
| Rate for Payer: Aetna Commercial |
$44.96
|
| Rate for Payer: Aetna Medicare |
$44.96
|
| Rate for Payer: Aetna Medicare |
$44.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$38.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$38.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$38.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$38.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$38.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$38.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$38.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$38.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$41.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$41.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$51.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$51.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$49.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$49.46
|
| Rate for Payer: Cash Price |
$50.30
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Centivo All Commercial |
$69.69
|
| Rate for Payer: Centivo All Commercial |
$69.69
|
| Rate for Payer: Cigna All Commercial |
$44.96
|
| Rate for Payer: Cigna All Commercial |
$44.96
|
| Rate for Payer: CORVEL All Commercial |
$44.96
|
| Rate for Payer: CORVEL All Commercial |
$44.96
|
| Rate for Payer: Coventry All Commercial |
$53.95
|
| Rate for Payer: Coventry All Commercial |
$53.95
|
| Rate for Payer: Encore All Commercial |
$44.96
|
| Rate for Payer: Encore All Commercial |
$44.96
|
| Rate for Payer: Frontpath All Commercial |
$50.48
|
| Rate for Payer: Frontpath All Commercial |
$50.48
|
| Rate for Payer: Humana ChoiceCare |
$34.78
|
| Rate for Payer: Humana ChoiceCare |
$34.78
|
| Rate for Payer: Humana Medicare |
$44.96
|
| Rate for Payer: Humana Medicare |
$44.96
|
| Rate for Payer: Lucent All Commercial |
$62.94
|
| Rate for Payer: Lucent All Commercial |
$62.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$69.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$69.00
|
| Rate for Payer: Managed Health Services Medicaid |
$41.24
|
| Rate for Payer: Managed Health Services Medicaid |
$41.24
|
| Rate for Payer: MDWise Medicaid |
$41.24
|
| Rate for Payer: MDWise Medicaid |
$41.24
|
| Rate for Payer: PHCS All Commercial |
$44.96
|
| Rate for Payer: PHCS All Commercial |
$44.96
|
| Rate for Payer: PHP All Commercial |
$61.97
|
| Rate for Payer: PHP All Commercial |
$61.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$44.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$44.96
|
| Rate for Payer: Sagamore Health Network All Products |
$44.96
|
| Rate for Payer: Sagamore Health Network All Products |
$44.96
|
| Rate for Payer: Signature Care EPO |
$39.15
|
| Rate for Payer: Signature Care EPO |
$39.15
|
| Rate for Payer: Signature Care PPO |
$39.15
|
| Rate for Payer: Signature Care PPO |
$39.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,500.00
|
| Rate for Payer: United Healthcare Commercial |
$31.99
|
| Rate for Payer: United Healthcare Commercial |
$31.99
|
|
|
PR PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB
|
Professional
|
Both
|
$98.46
|
|
|
Service Code
|
CPT 93287
|
| Hospital Charge Code |
z93287
|
| Min. Negotiated Rate |
$42.33 |
| Max. Negotiated Rate |
$7,600.00 |
| Rate for Payer: Aetna Commercial |
$52.18
|
| Rate for Payer: Aetna Commercial |
$52.18
|
| Rate for Payer: Aetna Medicare |
$52.18
|
| Rate for Payer: Aetna Medicare |
$52.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$50.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$50.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$50.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$50.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$50.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$50.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$50.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$50.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$60.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$60.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$57.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$57.40
|
| Rate for Payer: Cash Price |
$58.51
|
| Rate for Payer: Cash Price |
$59.08
|
| Rate for Payer: Centivo All Commercial |
$80.88
|
| Rate for Payer: Centivo All Commercial |
$80.88
|
| Rate for Payer: Cigna All Commercial |
$52.18
|
| Rate for Payer: Cigna All Commercial |
$52.18
|
| Rate for Payer: CORVEL All Commercial |
$52.18
|
| Rate for Payer: CORVEL All Commercial |
$52.18
|
| Rate for Payer: Coventry All Commercial |
$62.62
|
| Rate for Payer: Coventry All Commercial |
$62.62
|
| Rate for Payer: Encore All Commercial |
$52.18
|
| Rate for Payer: Encore All Commercial |
$52.18
|
| Rate for Payer: Frontpath All Commercial |
$58.70
|
| Rate for Payer: Frontpath All Commercial |
$58.70
|
| Rate for Payer: Humana ChoiceCare |
$46.02
|
| Rate for Payer: Humana ChoiceCare |
$46.02
|
| Rate for Payer: Humana Medicare |
$52.18
|
| Rate for Payer: Humana Medicare |
$52.18
|
| Rate for Payer: Lucent All Commercial |
$73.05
|
| Rate for Payer: Lucent All Commercial |
$73.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$81.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$81.00
|
| Rate for Payer: Managed Health Services Medicaid |
$47.96
|
| Rate for Payer: Managed Health Services Medicaid |
$47.96
|
| Rate for Payer: MDWise Medicaid |
$47.96
|
| Rate for Payer: MDWise Medicaid |
$47.96
|
| Rate for Payer: PHCS All Commercial |
$52.18
|
| Rate for Payer: PHCS All Commercial |
$52.18
|
| Rate for Payer: PHP All Commercial |
$72.36
|
| Rate for Payer: PHP All Commercial |
$72.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$52.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$52.18
|
| Rate for Payer: Sagamore Health Network All Products |
$52.18
|
| Rate for Payer: Sagamore Health Network All Products |
$52.18
|
| Rate for Payer: Signature Care EPO |
$51.82
|
| Rate for Payer: Signature Care EPO |
$51.82
|
| Rate for Payer: Signature Care PPO |
$51.82
|
| Rate for Payer: Signature Care PPO |
$51.82
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,600.00
|
| Rate for Payer: United Healthcare Commercial |
$42.33
|
| Rate for Payer: United Healthcare Commercial |
$42.33
|
|
